Patient Information

Patient Rights	Patient Access to Records
Lodging Complaints	Spectacle Prescriptions
Ethics and Informed Consent	Contact Lens Prescriptions

Guidelines on the release of Spectacle and Contact Lens Prescriptions by Optometrists
Release of prescriptions The most common outcome of an optometric examination is the generation of a prescription for an optical appliance. This statement is intended to provide guidance to optometrists on the provision of prescriptions to patients and to other persons. Complaints please be advised, membership of this association is voluntary and optometrist members do not have to cooperate in the complaint resolution process if they so choose. Definition A prescription for an optical appliance is a written order detailing all parameters necessary for the correct fabrication of the prescribed appliance, and signed by an optometrist. The prescription is an order to a third party to provide the ophthalmic goods specifically described.(1) Release of prescriptions to patients A patient of an optometrist has a right to request and receive a copy of a spectacle or contact lens prescription when such a prescription has been determined during an examination, following payment of the fee or assignment of Medicare benefits. This right is provided both by common law, and by Medicare regulations that are binding on all participating optometrists.(2) No additional fee should be charged for providing a copy of the prescription at the conclusion of an examination. A patient has the right to receive a copy of the prescription, at any time after the prescription has been determined. When a patient requests a copy of the prescription after the prescription has expired, this fact should be explained to the patient who still has a right to a copy of the prescription, which should be marked 'expired'. Spectacle prescriptions Patients have a right to request and receive a copy of their spectacle prescription at the conclusion of any consultation at which a prescription is generated. If the patient already wears spectacles, and no change to their prescription is needed, they still have a right to the prescription. If a patient does not require spectacles, no prescription need be issued. Patients should be informed of their right to a copy of their prescription before any dispensing (including selecting a frame) has occurred. This can be done by posting a notice to this effect in the practice where it will be seen by patients. Contact lens prescriptions Patients have a right to request and receive a copy of their contact lens prescription as soon as this has been determined. This may not be at the conclusion of the initial fitting consultation. A final prescription should not be issued until the optometrist can state with confidence that the patient can wear contact lenses and that the prescribed lenses will provide the patient with proper vision, comfort and freedom from injury, provided the prescription is correctly filled and the patient follows the recommended lens care and wearing instructions.(3) Typically this will not be possible until the patient has completed a trial wearing period of some weeks or months, and their response to the lenses has been ascertained. To avoid misunderstandings, when a patient requests a contact lens prescription at the conclusion of an initial fitting consultation, the optometrist should explain that a prescription cannot be supplied until the optometrist is satisfied that they have determined the correct prescription for the patient. A preliminary prescription, valid for a limited time, may be issued to allow the patient to purchase an initial pair of trial lenses. A final prescription should be issued on request as soon as the optometrist is satisfied that the lenses fit and perform correctly. As with spectacle prescriptions, an expiry date should be included. Release of prescriptions to third parties Optometrists should not release a patient's prescription to a third party without the permission of the patient. When an optometrist is requested to provide a patient's prescription to a third party, the optometrist should satisfy themselves that the patient has authorised the release of the prescription. This can be achieved in person, by telephone, or in writing, but the optometrist needs to be sure that it is the patient authorising the request. This does not apply in the case of Health Insurance Funds requesting details of a patient's prescription because the patient signs away their right to confidentiality in this area when they lodge their claim. However, any concerns that the optometrist has in this area can in part be overcome by including the patient's prescription on the receipt for their spectacles or contact lenses when the optometrist has provided these items. It then becomes the patient's decision to provide their prescription details when they hand their receipt to the health care fund for their claim. Wherever possible, prescriptions should be provided in written form, either by mail or facsimile. Contents of prescriptions The prescription contains instructions to the dispenser on the parameters of the appliance to be provided. Prescriptions should clearly identify the prescribing optometrist, the patient for whom the appliance was prescribed, the date of issue and the expiry date of the prescription (after this date, the prescription should not be filled). Ideally prescriptions should be presented on practice stationery, which could be custom designed for this purpose. Prescriptions for optical appliances, whether spectacles or contact lenses, should contain all information necessary to ensure accurate dispensing of the prescribed appliances. Minimum requirements for a spectacle prescription include lens powers and pupillary distance. Other information should be specified when the optometrist has determined that a specific lens type is important for the patient's needs. This may include intended use of the appliance, lens form, lens materials, lens treatments (tints, coating, hardening), other lens parameters. For example, if the optometrist has determined that the patient requires impact resistant lenses, this must be specified. Prescriptions should also clearly state whether they are for spectacles or contact lenses. Prescription expiry dates People's eyes and vision change over time, and a person's requirements for optical correction also change. To prevent patients being inadvertently supplied with inappropriate optical appliances, all prescriptions should carry an expiry date. When nominating an expiry date for a prescription, the optometrist should choose a date beyond which they are not willing to state that the prescription will give the best visual and physiological performance. For spectacle prescriptions, the most common expiry date is two years after the examination at which the prescription was determined. In some cases, shorter or longer expiry dates may be appropriate. For contact lens prescriptions, the most appropriate expiry date is generally the date of the next scheduled aftercare examination, which may be only a few months later. References 1. Classe JG. Release of spectacle prescriptions: an update. J Amer Optom Assoc 1996, 67: 631-637. 2. Australian Government Department of Health and Ageing. Medicare benefits for services by optometrists, November 2003. 3. Classe JG. Legal aspects of optometry. Stoneham: Butterworths, 1989: 384.

Release of prescriptions

The most common outcome of an optometric examination is the generation of a prescription for an optical appliance. This statement is intended to provide guidance to optometrists on the provision of prescriptions to patients and to other persons.

Complaints please be advised, membership of this association is voluntary and optometrist members do not have to cooperate in the complaint resolution process if they so choose.

Definition

A prescription for an optical appliance is a written order detailing all parameters necessary for the correct fabrication of the prescribed appliance, and signed by an optometrist. The prescription is an order to a third party to provide the ophthalmic goods specifically described.(1)

Release of prescriptions to patients

A patient of an optometrist has a right to request and receive a copy of a spectacle or contact lens prescription when such a prescription has been determined during an examination, following payment of the fee or assignment of Medicare benefits. This right is provided both by common law, and by Medicare regulations that are binding on all participating optometrists.(2) No additional fee should be charged for providing a copy of the prescription at the conclusion of an examination.

A patient has the right to receive a copy of the prescription, at any time after the prescription has been determined. When a patient requests a copy of the prescription after the prescription has expired, this fact should be explained to the patient who still has a right to a copy of the prescription, which should be marked 'expired'.

Spectacle prescriptions

Patients have a right to request and receive a copy of their spectacle prescription at the conclusion of any consultation at which a prescription is generated. If the patient already wears spectacles, and no change to their prescription is needed, they still have a right to the prescription. If a patient does not require spectacles, no prescription need be issued.

Patients should be informed of their right to a copy of their prescription before any dispensing (including selecting a frame) has occurred. This can be done by posting a notice to this effect in the practice where it will be seen by patients.

Contact lens prescriptions

Patients have a right to request and receive a copy of their contact lens prescription as soon as this has been determined. This may not be at the conclusion of the initial fitting consultation.

A final prescription should not be issued until the optometrist can state with confidence that the patient can wear contact lenses and that the prescribed lenses will provide the patient with proper vision, comfort and freedom from injury, provided the prescription is correctly filled and the patient follows the recommended lens care and wearing instructions.(3) Typically this will not be possible until the patient has completed a trial wearing period of some weeks or months, and their response to the lenses has been ascertained.

To avoid misunderstandings, when a patient requests a contact lens prescription at the conclusion of an initial fitting consultation, the optometrist should explain that a prescription cannot be supplied until the optometrist is satisfied that they have determined the correct prescription for the patient. A preliminary prescription, valid for a limited time, may be issued to allow the patient to purchase an initial pair of trial lenses. A final prescription should be issued on request as soon as the optometrist is satisfied that the lenses fit and perform correctly. As with spectacle prescriptions, an expiry date should be included.

Release of prescriptions to third parties

Optometrists should not release a patient's prescription to a third party without the permission of the patient.

When an optometrist is requested to provide a patient's prescription to a third party, the optometrist should satisfy themselves that the patient has authorised the release of the prescription. This can be achieved in person, by telephone, or in writing, but the optometrist needs to be sure that it is the patient authorising the request. This does not apply in the case of Health Insurance Funds requesting details of a patient's prescription because the patient signs away their right to confidentiality in this area when they lodge their claim. However, any concerns that the optometrist has in this area can in part be overcome by including the patient's prescription on the receipt for their spectacles or contact lenses when the optometrist has provided these items. It then becomes the patient's decision to provide their prescription details when they hand their receipt to the health care fund for their claim.

Wherever possible, prescriptions should be provided in written form, either by mail or facsimile.

Contents of prescriptions

The prescription contains instructions to the dispenser on the parameters of the appliance to be provided.

Prescriptions should clearly identify the prescribing optometrist, the patient for whom the appliance was prescribed, the date of issue and the expiry date of the prescription (after this date, the prescription should not be filled). Ideally prescriptions should be presented on practice stationery, which could be custom designed for this purpose.

Prescriptions for optical appliances, whether spectacles or contact lenses, should contain all information necessary to ensure accurate dispensing of the prescribed appliances. Minimum requirements for a spectacle prescription include lens powers and pupillary distance. Other information should be specified when the optometrist has determined that a specific lens type is important for the patient's needs. This may include intended use of the appliance, lens form, lens materials, lens treatments (tints, coating, hardening), other lens parameters. For example, if the optometrist has determined that the patient requires impact resistant lenses, this must be specified.

Prescriptions should also clearly state whether they are for spectacles or contact lenses.

Prescription expiry dates

People's eyes and vision change over time, and a person's requirements for optical correction also change. To prevent patients being inadvertently supplied with inappropriate optical appliances, all prescriptions should carry an expiry date.

When nominating an expiry date for a prescription, the optometrist should choose a date beyond which they are not willing to state that the prescription will give the best visual and physiological performance. For spectacle prescriptions, the most common expiry date is two years after the examination at which the prescription was determined. In some cases, shorter or longer expiry dates may be appropriate. For contact lens prescriptions, the most appropriate expiry date is generally the date of the next scheduled aftercare examination, which may be only a few months later.

References

1. Classe JG. Release of spectacle prescriptions: an update. J Amer Optom Assoc 1996, 67: 631-637.

2. Australian Government Department of Health and Ageing. Medicare benefits for services by optometrists, November 2003.

3. Classe JG. Legal aspects of optometry. Stoneham: Butterworths, 1989: 384.